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Reproducibility of coronary plaque detection and characterization using low radiation dose coronary computed tomographic angiography in patients with intermediate likelihood of coronary artery disease (ReSCAN study)

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Abstract

The purpose of this study is to evaluate the interscan, interobserver and intraobserver agreement for coronary plaque detection, and characterization using low radiation dose high-pitch spiral acquisition coronary CT angiography (CTA). Two experienced observers independently evaluated coronary CTA datasets from 50 consecutive patients undergoing two 128-slice dual source CT scans within 12 days. Mean (±SD) estimated radiation exposure was 1.5 ± 0.2 mSv per scan. Observers recorded the presence and characterization of coronary plaques as non-calcified or calcified. A “segment involvement score” (SIS) was computed by summing the numbers of segments with any coronary plaque per patient. Reproducibility was assessed using kappa (κ) statistics, paired t test and Bland–Altman analyses. Interscan, interobserver, and intraobserver agreement (κ-values) for detection of any or calcified plaques were 83–94% (κ-values 0.57–0.85), and 67–84% (0.31–0.67) for non-calcified plaques on a patient level. No significant difference was observed in mean interscan or interobserver SIS. Mean (95% CI) intraobserver SIS difference was −0.88 (−1.25; −0.51), P < 0.001, with limits of agreement from −4.7 to 2.9. Low radiation dose high-pitch coronary CTA permits detection of any or calcified plaques with high interscan, interobserver, intraobserver agreement. However, variability for the detection of non-calcified plaque is substantial.

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Acknowledgments

Kristian Altern Øvrehus was supported by a grant from Vejle Hospital Research Foundation, Vejle, Denmark, and by a PhD scholarship from Aarhus University, Faculty of Health Sciences, Aarhus, Denmark. Stephan Achenbach and Mohamed Marwan were funded by Bundesministerium für Bildung und Forschung (BMBF), Bonn, Germany [grant BMBF 01 EV 0708]. The invaluable assistance from Kamilla Pedersen, Susie Mortensen, Lena Lassen, Connie Uldall, Anna Mihare and Rikke Mols in conducting this study is much appreciated.

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Øvrehus, K.A., Marwan, M., Bøtker, H.E. et al. Reproducibility of coronary plaque detection and characterization using low radiation dose coronary computed tomographic angiography in patients with intermediate likelihood of coronary artery disease (ReSCAN study). Int J Cardiovasc Imaging 28, 889–899 (2012). https://doi.org/10.1007/s10554-011-9895-1

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  • DOI: https://doi.org/10.1007/s10554-011-9895-1

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